Individual provider Active NPI

Abid Iqbal Khan, MD

  • Psychiatry Physician
  • Amityville, NY
National Provider Identifier
1932288735
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
197151 Issued in NY
Practice address
81 Louden Ave
Amityville, NY 11701-2736
Phone
(631) 789-7885
NPI assigned
Nov 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 197151 NY Primary

Addresses

Primary practice location

81 Louden Ave
Amityville, NY 11701-2736

Mailing address

12 Harbor Crest Court
Huntington, NY 11743-1213
Phone (631) 789-7885

Other identifiers 1

IdentifierTypeStateIssuer
01782847MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070924000553 NY Practitioner - Psychiatry 3375637127 Reassigns benefits to 1 organization
Practice locations: Amityville, NY

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

366 Broadway
Amityville, NY 11701-2711
Phone (631) 789-7064

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
197151NYMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brunswick Hospital Center, Inc CurrentSince Oct 31, 2016 Accepting new patients
Brunswick Hospital Center, Inc CurrentSince Oct 31, 2016 Accepting new patients

Locations

81 Louden Ave
Amityville, NY 11701
Phone (631) 789-7000

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: ehr-direct@brunswick.hin.us

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1932288735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 HARBOR CREST COURT",
            "city": "HUNTINGTON",
            "state": "NY",
            "postal_code": "117431213",
            "telephone_number": "631-789-7885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 LOUDEN AVE",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012736",
            "telephone_number": "631-789-7885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAN",
        "first_name": "ABID",
        "middle_name": "IQBAL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "197151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01782847",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Amityville, NY

Sources for this page

Verify at the official NPI Registry.